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General NPI Number Information
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NPI Number | 1639615826
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Entity Type | Individual
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Provider Name | CHRIS LOFTIS PHD, PMP
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Gender | Male
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 4250 N. FAIRFAX DRIVE SUITE 600 #4777
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City | ARLINGTON
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State | VA
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Zip | 22203
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Country | US
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Telephone | 202-681-5357
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Fax |
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Provider Business Mailing Address
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Address Line | 9480 MAIN ST # 1018
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City | FAIRFAX
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State | VA
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Zip | 22031-4032
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Country | US
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Telephone | 703-519-6186
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY1000527
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License Number State | VA
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